Treatment Response in Advanced and Metastatic Esophageal Cancer Patients on Palliative Treatments in Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia: A Retrospective Study

Background: Greater than 90 % of oesophageal cancer patients present at an advanced and or metastatic stage in low-income countries including Ethiopia which are also hot spot for this cancer. But there is limited study done on palliative treatment response in Ethiopia. So this study seeks on palliative treatment responses in advanced and metastatic oesophageal cancer patients in the oncology department at TASH. Method: The study is a retrospective cohort of 70 patients with advanced and metastatic oesophageal cancer patients who took palliative treatment at Tikur Anbesa Hospital from June 20, 2019 to November 10, 2022. Data were retrieved from the Hospital-based Cancer Registry to identify patients with esophageal cancers. The overall survival rate was calculated by the Kaplan-Meir method and the correlates between clinical parameters and prognostic significance were estimated by the long-rank test using SPSS version 26.0. We applied a p-value of 0.25 from bivariate to multivariate cox regression analysis and decided a significant at p value of less than 0.05 at multivariate cox-regression analysis. Results: Among the total 70 patients reviewed for this study, 97.6% of them had planned treatment and among those 68.8% took chemotherapy, and 28.6% took surgery. The median overall survival was 17 months. Chemotherapy treatment with chemotherapy has shown overall response rate (ORR) of 21.1%, 18.8% and 3.5% at mid-cycle, end-cycle, and 4 months after completion of chemotherapy respectively. The study also showed that there was at least one-grade improvement of dysphagia in 30% at end-cycle of chemotherapy, and 15% of patients after one month of surgery respectively. The study also highlighted treatment without surgery has a 61.6 % decreased risk of esophageal cancer death (AHR=0.384, 95 CI: 0.161-0.913, P<0.03). Conclusion: Although median overall survival seems higher compared to studies in another part of the world including Africa, Overall response rate and symptomatic dysphagia improvement is very low after completion of chemotherapy and palliative surgery.